Graphic Communications
Intern Placement Form

This form must be completed immediately upon acceptance of an approved internship in order to notify Mrs. Leininger, the GC Internship Coordinator.

Note: Please read the Internship Rules. By submitting this form, it will be assumed that you know and understand your responsibilities as an intern.

Student's Information
Name Student ID #
Clemson E-Mail    
Student's Cell Phone Parent's Phone


Internship Information
Which internship is this?  1st     2nd     3rd     4th
Term  Fall     Spring     Summer Year   
Date Position Accepted
Date to Start Internship


Company Information
Company Name Company's URL
Company Address    
City, State Zip Code
Phone Number Fax Number


Contact Person from Company
Name Title
E-Mail Phone Number


If Second Internship, Previous Internship Information
Where was your 1st internship?   
Term:      Fall     Spring     Summer Year   


Internship Rules
Did you read and understand the Internship Rules?    Yes    No